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A DIGITAL PUSH FOR HEALTHCARE

Focus: GS-II Social Justice

Introduction

  • A personal health record (PHR) is a health record where health data and other information related to the care of a patient is maintained by the patient.
  • An electronic health record (EHR) is the systematized collection of patient and population electronically-stored health information in a digital format, which can be shared across different health care settings.
  • In India, there is an increase in the magnitude of digitization of healthcare services in various healthcare delivery institutions.
  • However, the digitised medical records in India now, are more institution centric as these are limited to specific/ defined healthcare delivery institutions only.
  • Further, the clinical data resides in silos and usually, access of this data is not extended to the patients, who often struggle with paper-based record keeping.

India’s Steps – Personal Health Record (PHR)

  • The Union Ministry of Health and Family Welfare had developed an app in 2019 which allows users to store their detailed health profile, past prescriptions, lab records and diagnoses at one platform that they can share with medical professionals when they need.
  • The app precludes the need to carry medical records when patients visit their doctors.
  • The app, ‘My Health Record,’ was developed by the Centre for Development of Advanced Computing under the Ministry for Information Technology.
  • The app, equipped with multi-factor authentication, is part of a mega National Digital Health Blueprint that the Centre has prepared after wide consultations.
  • This move is aimed at empowering people with a one-stop forum to store all the details of their health which they can share with professionals even if they are not carrying physical files around.

What is the National Health Stack (NHS)?

Unveiled by the NITI Aayog in 2018, NHS is digital infrastructure built with the aim of making the health insurance system more transparent and robust.

There are five components of NHS:

  1. Electronic national health registry that would serve as a single source of health data for the nation;
  2. Coverage and claims platform that would serve as the building blocks for large health protection schemes, allow for the horizontal and vertical expansion of schemes like Ayushman Bharat by states, and enable a robust system of fraud detection;
  3. Federated personal health records (PHR) framework that would serve the twin purposes of access to their own health data by patients, and the availability of health data for medical research, which is critical for advancing the understanding of human health;
  4. National health analytics platform that would provide a holistic view combining information on multiple health initiatives, and feed into smart policymaking, for instance, through improved predictive analytics; and
  5. Other horizontal components including a unique digital health ID, health data dictionaries and supply chain management for drugs, payment gateways, etc., shared across all health programmes.

What is National Digital Health Mission (NDHM)?

  • To establish and manage the core digital health data and the infrastructure required, National Digital Health Mission (NDHM), was recommended to be established as a purely government organization with complete functional autonomy on the lines of Unique Identification Authority of India (UIDAI) and Goods and Services Network GSTN.
  • The Objectives of NDHB are aligned to the Vision of National Health Policy 2017 and the Sustainable Development Goals (SDGs) relating to the health sector.

The Main Objectives of NDHM are:

  1. Promoting the adoption of open standards by all the actors in the National Digital Health Ecosystem (NDHE), for developing several digital health systems that span across the sector from wellness to disease management.
  2. Creating a system of Personal Health Records, based on international standards, and easily accessible to the citizens and to the service providers, based on citizen-consent.
  3. Following the best principles of cooperative federalism while working with the States and Union Territories for the realization of the Vision.
  4. Promoting Health Data Analytics and Medical Research.

National Digital Health Blueprint (NDHB), released by Union Minister of Health and Family Welfare in 2019, handles the requirements of Unique identification of Persons, Facilities, Diseases and Devices through 2 Building Blocks, namely, Personal Health Identifier (PHI), and Health Master Directories & Registries.

Way Forward: Towards Successful Digitization

  • To enable seamless data exchange, all users must be incentivised or mandated to adopt a standard language of communication.
  • India must harness advances in voice recognition, natural language processing, and machine learning to ignite its health data ecosystem without straining its over-burdened physicians and community health workers.
  • The concerns with universal IDs are particularly salient when it comes to sensitive personal data like health data, and hence the security concerns must be addressed thoroughly.
  • Hospital ethics boards and national data privacy laws are only now grappling with difficult questions about third-party use, hence, formulation of stringent rules and policies regarding the use and storage of sensitive data collected and implementation of these rules will be crucial.
  • The proposed NDHM architecture, if executed as intended, has two distinguishing characteristics that may help ameliorate the concerns regarding data – the NDHM is non-prescriptive, and steers away from designing a monolithic EMR (electronic medical record) and instead only provides the scaffolding upon which the market can compete to develop a range of applications that would facilitate data exchange between patients, providers and payers.
  • The NDHM architecture seeks to protect patients by the rather elegant use of the consent manager framework that has already been successfully used by the Universal Payment Interface.

Conclusion

The portability of clinically-relevant data across private-public divides and states will cut costs and save time, the ability to monitor compliance, say, with responsible use of antibiotics, can profoundly alter practice and improve the quality of care, and the ability to conduct timely institution-based syndromic surveillance may alter the course of an epidemic, and of a nation.

-Source: Indian Express

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October 2022
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